Community-Based Initiatives Improving Maternal and Child Health in Democratic Republic of the Congo
It is 1 p.m. in Mwene Ditu, a crossroads town in the province of Kasaï Oriental, the nexus of diamond mining in Democratic Republic of the Congo (DRC). Fortunée Kabeya* has just given birth at the Muaka health center. Céline Bukasa, the head nurse, assisted Fortunée’s delivery, and mother and baby are doing well.
The US Agency for International Development (USAID)-funded Integrated Health Project (IHP) in the DRC, managed by Management Sciences for Health (MSH), promotes deliveries in health facilities or in the presence of a skilled birth attendant. Encouraging women to deliver at health facilities is essential to reducing maternal mortality in the DRC, where only 80 percent of births are assisted by a skilled health provider#_ftn1"> and maternal mortality is estimated at 730 deaths per 100,000 live births#_ftn2">. As part of this effort, IHP partnered with the Network of Congolese Associations of Youth against AIDS (RACOJ) to educate Mwene Ditu residents on the benefits of giving birth in a health facility and using family planning methods, two practices that improve maternal and child health.
IHP Behavior Change Communication (BCC) staff trained RACOJ facilitators in Education Through Listening (ETL), an innovative interpersonal communication approach that engages community leaders in dialogues with community members on health issues. Under ETL, the paradigm shifts from lecturing to personal and community participation for problem solving. RACOJ conducted ETL sessions between June and July 2014 to raise the awareness of women in the community of the health benefits of modern family planning, both for themselves and their children.
As a result, the number of new acceptors of Implanon in the Mwene Ditu health zone, including Mwaka, Alpha, and Tshamala health facilities, increased from six in January, prior to the ETL sessions, to 124 in August 2014, after the completion of the sessions#_ftn3">.
“RACOJ was a big help in the success of this campaign,” said Ms. Bukasa. “There was an increase in the number of women who came to the center either to choose a family planning method or get more information.”
Clément Tshibanda, Mwene Ditu’s IHP BCC technical advisor, said that ETL, along with other project-led community-based awareness-raising initiatives, contributed to the increase in the number of women of childbearing age who use a contraceptive method in the Mwene Ditu health zone from 15 percent at the beginning of the project in 2010 to 25 percent currently; and to the increase in the proportion of births assisted by a skilled attendant, from 73 to 95 percent.
Led by Management Sciences for Health with partners International Rescue Committee and Overseas Strategic Consulting Ltd., USAID/DRC-IHP is working to improve the basic health conditions of the Congolese people in 78 health zones in four provinces.
*Patient names changed to protect privacy.
#_ftnref1"> Democratic Republic of Congo: Demographic Health Survey 2013-2014-Preliminary report
#_ftnref2"> WHO, UNICEF, UNFPA, The World Bank, and United Nations Population Division Maternal Mortality Estimation Inter-Agency Group Democratic Republic of the Congo
#_ftnref3"> USAID/IHP Mwene Ditu coordination office monitoring and evaluation data